Trends in suicide and unemployment in Scotland, 1976-86.

To establish whether a correlation exists between unemployment and suicide the trends in the rates of both among men in Scotland during 1976-86 were studied. Both rates showed rapid increases in the late 1970s and then much slower increases after 1982. In contrast, among women, although the rate of unemployment followed a similar pattern, there was a gradual fall in the rate of suicide. The trends in regional unemployment for men during 1971-81 were compared with the suicide rates for the period before the increase (1974-7) and the period after the rapid increase (1983-6). No association was observed between trends in suicide and unemployment when analysed by health board areas or aggregates of local government districts. These data do not support the hypothesis that the rise in unemployment is a direct cause of the rise in suicide rates among men.     

Suicide among Manitoba's aboriginal people, 1988 to 1994

OBJECTIVE: To compare and contrast the characteristics of suicides among aboriginal and nonaboriginal people in Manitoba. DESIGN: Retrospective review of all suicides, based on a confidential analysis of records held by the Office of the Chief Medical Examiner. SETTING: Manitoba between 1988 and 1994. OUTCOME MEASURES: Standardized suicide rates, age- and sex-specific suicide rates, blood alcohol level at time of death, psychiatric help-seeking behaviour before suicide and residence on a reserve. RESULTS: Age-standardized suicide rates were 31.8 and 13.6 per 100,000 population per year among aboriginal and nonaboriginal people, respectively. The mean age of aboriginal people who committed suicide was 27.0 (standard deviation [SD] 10.8) years, compared with a mean age of 44.6 (SD 18.8) years for nonaboriginal people who committed suicide (p < 0.001). Blood alcohol levels at the time of death were a mean of 28 (SD 23) mmol/L among aboriginal people and 12 (SD 20) mmol/L among nonaboriginal people (p < 0.0001). Before their death, 21.9% of nonaboriginal suicide victims had sought psychiatric care whereas among aboriginal suicide victims 6.6% had sought care (p < 0.0001). Although the suicide rate was higher among aboriginal people living on reserve than among those living off reserve (52.9 v. 31.3 per 100,000 per year), both of these rates were substantially higher than the overall rates among nonaboriginal people. There were no significant differences in mean age, sex, blood alcohol level and previous psychiatric care among aboriginal people who committed suicide living on and off reserve. CONCLUSIONS: There was a high rate of suicide among Manitoba''s aboriginal people between 1988 and 1994; this rate was comparable to earlier estimates of national suicide rates among aboriginal people. The reserve environment does not, by itself, account for the high suicide rate among Manitoba''s aboriginal people. Further study of help-seeking behaviour and the association between alcohol abuse and suicide, particularly among aboriginal peoples, is indicated.     

Effects of socioeconomic factors on secular trends in suicide in Japan, 1953-86

The effects of socioeconomic factors on secular trends in suicide rates in Japan for the periods 1953-72 and 1973-86 were investigated using twelve socioeconomic indicators. Multiple regression analysis showed that the socioeconomic indicators affecting suicide rates were not identical in the two periods. The rates in both sexes in 1953-72 were closely related to unemployment rate and the labour force but between 1973 and 1986, divorce rate and the proportion in tertiary industry were most influential. The changes reflect the socioeconomic changes in industrial structure in Japan in transition from an industrial to a service economy.     

Suicide among Arab-Americans

Background

Arab-American (AA) populations in the US are exposed to discrimination and acculturative stress—two factors that have been associated with higher suicide risk. However, prior work suggests that socially oriented norms and behaviors, which characterize recent immigrant ethnic groups, may be protective against suicide risk. Here we explored suicide rates and their determinants among AAs in Michigan, the state with the largest proportion of AAs in the US.

Methodology/Principal Findings

ICD-9/10 underlying cause of death codes were used to identify suicide deaths from among all deaths in Michigan between 1990 and 2007. Data from the 2000 U.S. Census were collected for population denominators. Age-adjusted suicide rates among AAs and non-ethnic whites were calculated by gender using the direct method of standardization. We also stratified by residence inside or outside of Wayne County (WC), the county with the largest AA population in the state. Suicide rates were 25.10 per 100,000 per year among men and 6.40 per 100,000 per year among women in Michigan from 1990 to 2007. AA men had a 51% lower suicide rate and AA women had a 33% lower rate than non-ethnic white men and women, respectively. The suicide rate among AA men in WC was 29% lower than in all other counties, while the rate among AA women in WC was 20% lower than in all other counties. Among non-ethnic whites, the suicide rate in WC was higher compared to all other counties among both men (12%) and women (16%).

Conclusions/Significance

Suicide rates were higher among non-ethnic white men and women compared to AA men and women in both contexts. Arab ethnicity may protect against suicide in both sexes, but more so among men. Additionally, ethnic density may protect against suicide among Arab-Americans.     

Paraquat Prohibition and Change in the Suicide Rate and Methods in South Korea

The annual suicide rate in South Korea is the highest among the developed countries. Paraquat is a highly lethal herbicide, commonly used in South Korea as a means for suicide. We have studied the effect of the 2011 paraquat prohibition on the national suicide rate and method of suicide in South Korea. We obtained the monthly suicide rate from 2005 to 2013 in South Korea. In our analyses, we adjusted for the effects of celebrity suicides, and economic, meteorological, and seasonal factors on suicide rate. We employed change point analysis to determine the effect of paraquat prohibition on suicide rate over time, and the results were verified by structural change analysis, an alternative statistical method. After the paraquat prohibition period in South Korea, there was a significant reduction in the total suicide rate and suicide rate by poisoning with herbicides or fungicides in all age groups and in both genders. The estimated suicide rates during this period decreased by 10.0% and 46.1% for total suicides and suicides by poisoning of herbicides or fungicides, respectively. In addition, method substitution effect of paraquat prohibition was found in suicide by poisoning by carbon monoxide, which did not exceed the reduction in the suicide rate of poisoning with herbicides or fungicides. In South Korea, paraquat prohibition led to a lower rate of suicide by paraquat poisoning, as well as a reduction in the overall suicide rate. Paraquat prohibition should be considered as a national suicide prevention strategy in developing and developed countries alongside careful observation for method substitution effects.     

Suicides after pregnancy in Finland, 1987-94: register linkage study.

OBJECTIVE: To determine rates of suicide associated with pregnancy by the type of pregnancy. DESIGN: Register linkage study. Information on suicides in women of reproductive age was linked with the Finnish birth, abortion, and hospital discharge registers to find out how many women who committed suicide had had a completed pregnancy during her last year of life. SETTING: Nationwide data from Finland. SUBJECTS: Women who committed suicide in 1987-94. RESULTS: There were 73 suicides associated with pregnancy, representing 5.4% of all suicides in women in this age group. The mean annual suicide rate was 11.3 per 100,000. The suicide rate associated with birth was significantly lower (5.9) and the rates associated with miscarriage (18.1) and induced abortion (34.7) were significantly higher than in the population. The risk associated with birth was higher among teenagers and that associated with abortion was increased in all age groups. Women who had committed a suicide tended to come from lower social classes and were more likely to be unmarried than other women who had had a completed pregnancy. CONCLUSIONS: The increased risk of suicide after an induced abortion indicates either common risk factors for both or harmful effects of induced abortion on mental health.     

Prediction of fertility of bovine semen: Preliminary studies with the hamster egg penetration test

The ability of liposome-treated fresh and frozen spermatozoa from two bulls to interact with zona-free hamster oocytes was examined to show whether the in vitro test results would correspond with in vivo fertility as indicated by the 60 to 90 d nonreturn to service rates which, using frozen semen, were 77 and 59%, respectively. The motility of spermatozoa in washed suspensions was also rated. Hamster test results were obtained using three ejaculates from each bull both as fresh and frozen semen. The results with frozen semen corresponded with fertility. The averages of three hamster tests for oocyte penetration rates and mean number of spermatozoa per penetrated oocyte comparing spermatozoa from the bull with the higher fertility with spermatozoa from the bull with the lower fertility were 91% and 2.7 versus 56% and 1.4, respectively. Spermatozoa washed from frozen semen from the bull with the higher fertility interacted with hamster oocytes at the higher rate even when sperm motility was rated the same for both bulls. By contrast, fresh spermatozoa from the lower fertility bull interacted with hamster oocytes at a higher rate than spermatozoa from the higher fertility bull in six tests, comparing six ejaculates of fresh semen from both bulls. Comparing the higher fertility bull with the lower fertility bull, the average of six tests for oocyte penetration rates and mean number of spermatozoa per penetrated oocyte were 60% and 1.6 versus 89% and 3.0, respectively. This suggests that this hamster test cannot be used with fresh semen to predict relative levels of fertility of frozen semen. Also, the subjective rating of sperm motility did not correspond with the in vitro oocyte penetrating ability of the spermatozoa.     

Climate impact on suicide rates in Finland from 1971 to 2003

Seasonal patterns of death from suicide are well-documented and have been attributed to climatic factors such as solar radiation and ambient temperature. However, studies on the impact of weather and climate on suicide are not consistent, and conflicting data have been reported. In this study, we performed a correlation analysis between nationwide suicide rates and weather variables in Finland during the period 1971–2003. The weather parameters studied were global solar radiation, temperature and precipitation, and a range of time spans from 1 month to 1 year were used in order to elucidate the dose-response relationship, if any, between weather variables and suicide. Single and multiple linear regression models show weak associations using 1-month and 3-month time spans, but robust associations using a 12-month time span. Cumulative global solar radiation had the best explanatory power, while average temperature and cumulative precipitation had only a minor impact on suicide rates. Our results demonstrate that winters with low global radiation may increase the risk of suicide. The best correlation found was for the 5-month period from November to March; the inter-annual variability in the cumulative global radiation for that period explained 40 % of the variation in the male suicide rate and 14 % of the variation in the female suicide rate, both at a statistically significant level. Long-term variations in global radiation may also explain, in part, the observed increasing trend in the suicide rate until 1990 and the decreasing trend since then in Finland.     

Stable aggregate fertility in a time of family change: a decomposition of trends in American fertility, 1970-1999

Population-level birth rates in the United States were largely stable between 1970 and 1999. This stability contrasts with rapid change in marriage rates and fertility timing during the same period. In this article, I use decomposition techniques to analyze this seeming paradox. I decompose the general fertility rate into four components: age distribution, marital status, age-specific nonmarital fertility, and age-specific marital fertility. Absent other changes, declining time spent married would have led to substantial decline in fertility. Several factors combined to counterbalance these changes in marital behavior. Among white women in the 1970s and 1980s, marital fertility rates increased at older ages, consistent with a scenario in which women postponed both marriage and childbearing; increased nonmarital birth rates during this period were not a driving factor in overall fertility trends. Increased nonmarital fertility was more important in compensating for declining time spent married among African American women and among white women in the 1990s.     

Does diurnal temperature range influence seasonal suicide mortality? Assessment of daily data of the Helsinki metropolitan area from 1973 to 2010

Several studies show a peak in suicide rates during springtime and suggest differences in the seasonal variation of suicides. However, the seasonal distribution of the temperature impact on suicide is less clear. This study investigated the relationship between diurnal temperature range (DTR) on suicide mortality. Daily temperature and suicide data for Helsinki were analyzed for the period of 1973–2010 inclusive. Overall, DTR reached its maximum during the spring from mid-April to mid-June, which is also the season with highest suicide mortality in the study region. Specifically, the seasonal timing and maxima for both DTR and suicides vary from year to year. Time series analysis of DTR and suicide records revealed a significant (P?<?0.01) correlation between the springtime DTR maxima and suicide rates for males. No similar association could be found for females. These results provide evidence that a higher springtime DTR could be linked statistically to a higher seasonal suicide rate each spring, whereas the exact timing of the DTR peak did not associate with the seasonal suicide rate. A possible mechanism behind the springtime association between the DTR and suicides originates from brown adipose tissue (BAT) over-activity. Activation of BAT through the winter improves cold tolerance at the cost of heat tolerance. This might trigger anxiety and psychomotor agitation, affecting mood in a negative way. As a hypothesis, the compromised heat tolerance is suggested to increase the risk of death from suicide.     

National intelligence, suicide rate in the elderly, and a threshold intelligence for suicidality: an ecological study of 48 Eurasian countries

Across 85 countries around the world, Voracek (2004) found a significant positive relation between estimated national intelligence (IQ) and national male and female suicide rate. The relation was not attenuated when countries' per capita Gross Domestic Product (GDP) and type of national IQ estimation were statistically controlled. Independently, investigating the total national suicide rate only, Lester (2003) arrived at the same conclusion. These two findings are consistent with a corollary of de Catanzaro's (1981) evolutionary theory of human suicide, namely that a threshold intelligence is necessary for suicidality and that intelligence and suicide mortality should thus be positively related. Here, further evidence for this hypothesis is bolstered by focusing on suicide rates of the elderly. Across 48 Eurasian countries, estimated national IQ was significantly positively related to national suicide rates of people aged 65 years and over. This new ecological-level finding survived statistical controlling for a set of seven variables (type of national IQ estimation, national GDP, stableness and recency measures for suicide rates, and rates of adult literacy, urbanization and Roman Catholics), which thus are not confounding factors for the relation of intelligence and suicide mortality. Based on ecological data, the threshold IQ for suicidality is predicted to be 70 or slightly over, an estimate that is consistent with various suicidological observations.     

Alcohol consumption and rates of personal violence (suicide and homicide)

The present study examined the association between alcohol consumption and rates of personal violence (suicide and homicide) over regions within a nation. Although suicide rates were higher in regions with a higher per capital consumption of alcohol, other social variables were also found to be associated with both alcohol consumption and suicide rates, such as divorce rates and inter-region migration. Thus, it appears that alcohol consumption may be but one index of a broader sociocultural dimension that is associated with regional rates of suicidal behavior.     

Identification of germinal disk region derived genes potentially involved in hen fertility

Despite the regular decrease in fertility observed in hens, especially in “meat” lines, little is known about genes affecting fertility. We used the Affymetrix microarray to search for oocyte genes whose expression would vary in relation to fertility rate in both “laying” and “meat” line hens. We focused on oocyte genes because several of them have been found to be involved in fertility in other species. Based on microarray analysis, 54 and 84 genes were differentially expressed between germinal disc regions (GDR) of F1 maturation stage oocytes from hens exhibiting either high (100%) or low (from 22% to 80%) fertility rate from laying and meat lines respectively. Most of these differentially expressed genes were distributed between “laying” and “meat” lines indicating that mechanisms involved in the decrease in fertility rates in these two cases were independent. Real time RT‐PCR performed on the same samples which were used for microarray confirmed in several cases differences in gene expression levels detected by microarray. Moreover the correlations between gene expression levels and fertility rates were evaluated for the 10 most interesting genes at different stages of follicular maturation and early embryo development on individual GDR samples from hens exhibiting different fertility rates. In total, we identified five genes whose expression levels correlated with fertility rate in accordance with findings of microarray analysis and real time RT‐PCR: VWC2, CR407412, TAPA, FGL2, and TRAP6. The biological significance of these genes sheds light on potential mechanisms influencing fertility and could provide candidates for fertility markers in the hen. Mol. Reprod. Dev. 76: 1043–1055, 2009. © 2009 Wiley‐Liss, Inc.     

Fertility and legal abortion in England and Wales: performance indicators for family planning services.

The relation between fertility rates and legal abortion rates was investigated in a sample of health authorities in England and Wales to see how these varied. Total period fertility rates and total period legal abortion rates were derived from the average number of live births or legal abortions that would be experienced per woman if women experienced the age specific rates of the year in question throughout their childbearing years. The sample of 30 health authorities was selected by taking the districts with the highest and lowest fertility rates in each English region and in Wales in 1986. Total period fertility rates varied from 1.37 in Riverside to 2.42 in Tower Hamlets, while abortion rates varied from 0.25 in East Yorkshire to 0.99 in Riverside. When the two rates were added to provide a potential fertility rate it became clear that some districts with similar potential fertility rates had very different underlying component rates. Such comparisons can be used for service monitoring, indicating the need for better abortion and family planning services in districts with high fertility rates and for better family planning services in those with high abortion rates.     

Antidepressant Utilization and Suicide in Europe: An Ecological Multi-National Study

Background

Research concerning the association between use of antidepressants and incidence of suicide has yielded inconsistent results and is the subject of considerable controversy. The first aim is to describe trends in the use of antidepressants and rates of suicide in Europe, adjusted for gross domestic product, alcohol consumption, unemployment, and divorce. The second aim is to explore if any observed reduction in the rate of suicide in different European countries preceded the trend for increased use of antidepressants.

Methods

Data were obtained for 29 European countries between 1980 and 2009. Pearson correlations were used to explore the direction and magnitude of associations. Generalized linear mixed models and Poisson regression distribution were used to clarify the effects of antidepressants on suicide rates, while an autoregressive adjusted model was used to test the interaction between antidepressant utilization and suicide over two time periods: 1980–1994 and 1995–2009.

Findings

An inverse correlation was observed in all countries between recorded Standardised Death Rate (SDR) for suicide and antidepressant Defined Daily Dosage (DDD), with the exception of Portugal. Variability was marked in the association between suicide and alcohol, unemployment and divorce, with countries depicting either a positive or a negative correlation with the SDR for suicide. Every unit increase in DDD of an antidepressant per 1000 people per day, adjusted for these confounding factors, reduces the SDR by 0.088. The correlation between DDD and suicide related SDR was negative in both time periods considered, albeit more pronounced between 1980 and 1994.

Conclusions

Suicide rates have tended to decrease more in European countries where there has been a greater increase in the use of antidepressants. These findings underline the importance of the appropriate use of antidepressants as part of routine care for people diagnosed with depression, therefore reducing the risk of suicide.     

Ethnicity and suicide in Hawaii

Abstract

A multivariate model was built to investigate the effect of ethnicity on suicide in Hawaii. To provide the model with enough flexibility, both linear and nonlinear functions were employed. The three ethnic groups studied were Japanese, Caucasians, and Filipinos. The results show that Japanese have the highest tendency to commit suicide while the Filipinos have the lowest. However, the suicide rates of the three groups appear to be approaching a common value. While age and sex proved to be highly significant in explaining suicides, the magnitude and the form of their effect differ between one ethnic group and another. The trends of suicide rates for each ethnic group seem to be the least uniform. Suicide rates are decreasing for Japanese males and females and for Caucasian males. They are increasing for Caucasian females and Filipino males, while not changing for Filipino females.     

Age-specific fertility rates of the Jeju pony (<Emphasis Type="Italic"> Equus caballus</Emphasis>)

Age-specific fertility is an essential parameter of life history. Here we report age-specific fertility rates, measured as the number of foals per mare per year, for Jeju ponies aged 2–28 years. The total sample consisted of 545 foals produced by 178 mares from 1988 to 2002. The mean fertility rate across all ages of the mares was 0.65 foals/mare per year (±0.24 SD). The fertility rates were above average for the 7- to 8- and 19- to 20-year-old mares, whereas they were relatively low for mares under 4 years old. The fertility rates tended to increase with the age of the stallion, but the relationship was not significant (n =15, P =0.09). The incidence of inter-birth interval was not associated with the age that the mare first reproduced (n =64 mares, P =0.99). However, mares that reproduced later in life tended to have a reduced fertility rate due to an increase in the duration of inter-birth intervals relative to mares that reproduced earlier (n =4 years of first reproduction, P =0.068). The fertility rates of Jeju ponies were lower than for other horses, perhaps because only one stallion was introduced to a relatively large herd every year. We suggest that the introduction of more stallions to the herd each year would increase fertility rates.     

Why Has the Continuous Decline in German Suicide Rates Stopped in 2007?

Background

Whereas German suicide rates had a clear decreasing tendency between 1991 and 2006, they increased from 2007 to 2010. Deeper analyses of suicide data might help to understand better this change. The aim of this study was to analyze 1) whether recent trends can be related to changes in specific suicide methods and diverge by gender and age; 2) whether the decrease of suicide rates before 2007 as well as the increase from 2007 to 2010 are driven by the same suicide method.

Methods

Analyses were based on suicide data from the Federal Statistical Office of Germany. For 1998–2010, 136.583 suicide cases of men and women with known age and suicide method could be identified. These data were analyzed by joinpoint regression analysis, allowing identification of the best fitting point in time (“joinpoint”) at which the suicide rate significantly changes in magnitude or direction.

Results

The national downward trend between 1998 and 2007 was mainly due to corresponding changes in self-poisoning by other means than drugs (e.g., pesticides) (annual percentage change (APC) ≤ −4.33), drowning (APC ≤ −2.73), hanging (APC ≤ −2.69) and suicides by firearms (APC ≤ −1.46) in both genders. Regarding the overall increase of age-adjusted suicide rates in Germany 2007–2010, mainly the increase of self-poisoning (e.g., by drugs) and “being overrun” (APC ≥ 1.50) contributed to this trend.

Limitations

The true suicide rates might have been underestimated because of errors in the official death certificates.

Conclusions

Increase in suicide rates in Germany since 2007 went along with corresponding changes for “being overrun” and “self-poisoning”. Copycat suicides following the railway suicide of the goalkeeper Robert Enke partly contributed to the results. Thus, prevention of Werther effects and limitation of the availability of high pack sizes for drugs are of special relevance for the reversal of this trend.     

Suicide and Social Change in China

Using recently available data from China's Disease Surveillance Points system, we estimate that there are over 300,000 suicides in China per year; this makes suicide one of the most important causes of death in the country and makes the suicide rate in China one of the highest in the world. Moreover, the pattern of suicides in China is quite different than in other parts of the world – there are more completed suicides among females than males and rural rates are three-fold urban rates. The lack of reliable suicide data prior to 1987 makes it difficult to determine whether the rates are currently rising, falling, or staying constant. However, reports of suicides in the Chinese press and case studies conducted by the authors suggest (but do not prove) that the high rates of suicide currently experienced are related to the social changes that have occurred with the economic reforms (which started in 1978). Another possible explanation for the high rates of suicide is the large numbers of persons with depressive illness in China who remain untreated. Single-cause models of suicide (i.e., social factors or mental illness) do not do justice to the complexity of the processes involved and, therefore, do not provide useful information about the etiology and prevention of suicide in China or elsewhere. We describe our own dynamic model of suicide that includes five interacting factors which, we believe, collectively determine the suicide rates in a community.     

Association between the Density of Physicians and Suicide Rates in Japan: Nationwide Ecological Study Using a Spatial Bayesian Model

Background

Regional disparity in suicide rates is a serious problem worldwide. One possible cause is unequal distribution of the health workforce, especially psychiatrists. Research about the association between regional physician numbers and suicide rates is therefore important but studies are rare. The objective of this study was to evaluate the association between physician numbers and suicide rates in Japan, by municipality.

Methods

The study included all the municipalities in Japan (n = 1,896). We estimated smoothed standardized mortality ratios of suicide rates for each municipality and evaluated the association between health workforce and suicide rates using a hierarchical Bayesian model accounting for spatially correlated random effects, a conditional autoregressive model. We assumed a Poisson distribution for the observed number of suicides and set the expected number of suicides as the offset variable. The explanatory variables were numbers of physicians, a binary variable for the presence of psychiatrists, and social covariates.

Results

After adjustment for socioeconomic factors, suicide rates in municipalities that had at least one psychiatrist were lower than those in the other municipalities. There was, however, a positive and statistically significant association between the number of physicians and suicide rates.

Conclusions

Suicide rates in municipalities that had at least one psychiatrist were lower than those in other municipalities, but the number of physicians was positively and significantly related with suicide rates. To improve the regional disparity in suicide rates, the government should encourage psychiatrists to participate in community-based suicide prevention programs and to settle in municipalities that currently have no psychiatrists. The government and other stakeholders should also construct better networks between psychiatrists and non-psychiatrists to support sharing of information for suicide prevention.